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ib <br /> , b %,_-._, <br /> ! � <br /> Vii_ _,' �o�° l /� <br /> I <br /> intake &Approy.,9 Sheet I (POt-' PEI' 4T'STAFF ONLY) . PERMIT# C �"l D�- 06 <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Date: <br /> Iake Comments: Intake Comments: Assign To: <br /> ❑ Route to Commercial Building 0 Attach to Project No. <br /> ❑ Route to Residential Building 0 Route to Historic Reviewer <br /> ❑ Make this a"W"Permit ti` OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size ') O(il 0 Hold in Planning File Drawer <br /> Garage/Accessory.Struct.Size i i al Zone W. C <br /> Number of Stories 2. Overlay/Agreement V\'-O'- otr?limn <br /> Basement ONo ❑Yes, Fin/Unfin Nonresidential Use c----- <br /> Type of Construction Residential Use c S S . <br /> Occupancy Group ,l tAd Proposed No.of Dwelling Units: <br /> Occupancy Load Total No. of Dwelling Units: It <br /> Fire Sprinklers: ❑Update Existing Chew System ❑Not Req'd Planning/Landscape Inspection Required before Final? ❑Yes�No <br /> Reason Sprinklers Required: "In Lieu" Fee:Type: Amount$. <br /> Fire Alarm: ❑Update Existing Chew System El Not Req'd School Impact Fee: Total $ 0,/l,((' (KAA Z� <br /> Reason Fire Alarm Required: Calculated: Credit: t <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes 0 No ❑Everett School Dist ❑Mukilteo School Dist <br /> Add'I RCW 64.55 docs required prior to final? ❑Yes ❑No Additional Notes: —___....-- <br /> VALUATION CALCULATION: Total$ 6 a--1 L:0,00 <br /> 9,Dt54 - <br /> } Approved Date: 23 /�j <br /> PUBLIC WORKS I <br /> Intake OK by: Date: <br /> Additional Notes: Intake Comments: PW Worksheet Needed if: <br /> ❑Sys Dev Eval DTraffic Mit Eval <br /> ❑Site Work or Drainage Proposed <br /> Approved By: 2 <br /> Date: 4 .1L 9 ❑Backflow Prevention for high hazard: <br /> (dental,medical,animals,mortuary,hospital, <br /> supportive housing) <br /> FIRE DEPARTMENT DRoute this folder for PW Review at end ---PW Review Worksheet <br /> Intake: (Needed for Townhomes,Alley load SFR,New Commercial) ❑This project also has a separate concurrent PW Review(Green Folder) <br /> ❑Route to Fire Drawer--Fire Preliminary Review Notice AND ❑Create Green Folder DSubmitted Previously ❑Deferred <br /> ❑Sending Fire Notes to Project Team CiiThis Permit is Approved by Public Works <br /> Date: (OK to Route to Other Departments) gSee PW Review Worksheet and associated attached items <br /> Fire Sprinklers: ❑Update Existing ❑New System 0 Not Req'dn A Separate PW Permit is Required (Permit#: PWj90q-061f <br /> ) <br /> Fire Alarm: ❑Update Existing ❑New System 0 Not Req'd AND Is located in this folder <br /> Chemical Sup: ❑Update Existing ❑New System 0 Not Req'd 0 Is in a Separate Green Folder(join with this folder for permit issuance) <br /> Additional Notes: ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> improved By: Date: 1 0 Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: LIIRSIZol g <br />